2016-12-06_GENERAL DOCUMENTS - M2006017

• Permit No: M2006017
• IBM Index Class Name: GENERAL DOCUMENTS
• Doc Date: 12/6/2016
• Doc Name: Request for Documents/Information
• From: Jemadojin, LLC
• To: DRMS
• Email Name: TC1
• Media Type: D
• Archive: No

STATE OF COLORADO
DIVISION OF RECLAMATION,MINING AND SAFETY /
Department of Natural Resources 1 ( „ n f c G�1
1313 Sherman St., Room 215 l •�('�- (/ s� 'k
Denver,Colorado 80203 C O L ODIVIS t Ro N DSO
Phone:[phone] Document Imaging CD/DVD RECLAMATION
FAX:[phone] MINING
REQUEST FORM —&—
SAF ETY
Request for the DRMS document images on the following DRMS Permit file(s):
P,t rmit 0
The DRMS document images can be copied to either a CD or a DVD. Please check one below and returtll� OFR A
this form with your payment to DBMS. If a CD is requested and the permit is too tt),V!
a CD, you will be"G
- �r,�
CD @ $5.00 per disk DVD @ $20.00 per diskI
All-
�lPlease check if you want a copy of the Directions for Use of CD/DVD
The Permit File document images can be viewed in the reception area of the DRMS office, online at www.rnining.state.co.us, or
they can be purchased on a CD or DVD. The CD/DVD
//purchase cost covers the time and labor of making the CD/DVD.
Basic Instructions: L'K- a r'1'YI�sC
1. Insert CD/DVD into your disk drive
2. Click Yes to Accept the License Agreement for Lasertiche Plus Viewer
4. Lasertiche will Load, Opening the Start Page
5. Click on the Available Repository and Click Open, You are now ready to view the file(s).
DRMS cannot provide computer related support.
Disclaimer:
The Colorado Division of Reclamation, Mining and Safety (DRMS) is not responsible and shall not be liable to the user fol
damages of any kind arising out of the use of data or information provided by the DBMS, including the installation of the data o)
information, its use, or the results obtained from its use. Any data or information provided by the DRSM is provided "as is'
without warranty of any kind, either express or implied, including, but not limited to, the implied warranties of merchantability
and fitness for a particular purpose. Data or information provided by the DRMS shall be used and relied upon only at the user';
sole risk, and the user agrees to indemnify and hold harmless the DRMS, its officials, officers and employees from any liabilitl
arising out of the use of the data/information provided.
Customer Mailing and Contact Information:
DRMS use only
Print Name: I ► ` A R 1 � �.J I Ili 1'6�
CD/DVD create
Company: Y1'1 L- tested by:
Address: CC r1
-ZIEr" 1.LC'tG� S 0/1) �0 j'Q Date:
Phone: —7
Signature:
r'
l
Office of Office of
Mined Land Reclamation Denver Grand Junction Durango Active and Inactive Mines